Cognitive Enhancement Therapy in substance misusing schizophrenia: results of an 18-month feasibility trial.
Identifieur interne : 000834 ( PubMed/Checkpoint ); précédent : 000833; suivant : 000835Cognitive Enhancement Therapy in substance misusing schizophrenia: results of an 18-month feasibility trial.
Auteurs : Shaun M. Eack [États-Unis] ; Susan S. Hogarty [États-Unis] ; Deborah P. Greenwald [États-Unis] ; Maralee Y. Litschge [États-Unis] ; Summer A F. Mcknight [États-Unis] ; Srihari S. Bangalore [États-Unis] ; Michael F. Pogue-Geile [États-Unis] ; Matcheri S. Keshavan [États-Unis] ; Jack R. Cornelius [États-Unis]Source :
- Schizophrenia research [ 1573-2509 ] ; 2015.
Descripteurs français
- KwdFr :
- Abus de marijuana (), Abus de marijuana (psychologie), Adaptation sociale, Adulte, Alcoolisme (), Alcoolisme (psychologie), Cognition, Femelle, Humains, Mâle, Perception sociale, Psychologie des schizophrènes, Résultat thérapeutique, Schizophrénie (), Thérapie cognitive (), Troubles psychotiques (), Troubles psychotiques (psychologie), Études de faisabilité.
- MESH :
- psychologie : Abus de marijuana, Alcoolisme, Troubles psychotiques.
- Abus de marijuana, Adaptation sociale, Adulte, Alcoolisme, Cognition, Femelle, Humains, Mâle, Perception sociale, Psychologie des schizophrènes, Résultat thérapeutique, Schizophrénie, Thérapie cognitive, Troubles psychotiques, Études de faisabilité.
English descriptors
- KwdEn :
- Adult, Alcoholism (complications), Alcoholism (psychology), Alcoholism (therapy), Cognition, Cognitive Therapy (methods), Feasibility Studies, Female, Humans, Male, Marijuana Abuse (complications), Marijuana Abuse (psychology), Marijuana Abuse (therapy), Psychotic Disorders (complications), Psychotic Disorders (psychology), Psychotic Disorders (therapy), Schizophrenia (complications), Schizophrenia (therapy), Schizophrenic Psychology, Social Adjustment, Social Perception, Treatment Outcome.
- MESH :
- complications : Alcoholism, Marijuana Abuse, Psychotic Disorders, Schizophrenia.
- methods : Cognitive Therapy.
- psychology : Alcoholism, Marijuana Abuse, Psychotic Disorders.
- therapy : Alcoholism, Marijuana Abuse, Psychotic Disorders, Schizophrenia.
- Adult, Cognition, Feasibility Studies, Female, Humans, Male, Schizophrenic Psychology, Social Adjustment, Social Perception, Treatment Outcome.
Abstract
Substance use is a frequent problem in schizophrenia, and although many substance misusing patients with the disorder also experience considerable cognitive impairments, such individuals have been routinely excluded from clinical trials of cognitive remediation that could support their functional and addiction recoveries. This study conducted a small-scale feasibility trial of Cognitive Enhancement Therapy (CET) in substance misusing schizophrenia patients to assess the feasibility and efficacy of implementing comprehensive neurocognitive and social-cognitive remediation in this population. A total of 31 schizophrenia outpatients meeting addiction severity criteria for alcohol and/or cannabis use were randomized to 18months of CET or usual care. Feasibility findings indicated high degrees of satisfaction with CET, but also presented significant challenges in the recruitment and retention of substance misusing patients, with high levels of attrition (50%) over the study period, primarily due to positive symptom exacerbation. Intent-to-treat efficacy analyses showed large and significant improvements in neurocognition (d=.86), social cognition (d=1.13), and social adjustment (d=.92) favoring CET. Further, individuals treated with CET were more likely to reduce alcohol use (67% in CET vs. 25% in usual care) during treatment (p=.021). These results suggest that once engaged and stabilized, CET is a feasible and potentially effective treatment for cognitive impairments in patients with schizophrenia who misuse alcohol and/or cannabis. Substance misusing patients who are able to engage in treatment may be able to benefit from cognitive remediation, and the treatment of cognitive impairments may help improve substance use outcomes among this underserved population.
DOI: 10.1016/j.schres.2014.11.017
PubMed: 25510926
Affiliations:
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Keshavan</name><affiliation wicri:level="1"><nlm:affiliation>Department of Psychiatry, Harvard Medical School, United States.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Psychiatry, Harvard Medical School</wicri:regionArea><wicri:noRegion>Harvard Medical School</wicri:noRegion></affiliation></author><author><name sortKey="Cornelius, Jack R" sort="Cornelius, Jack R" uniqKey="Cornelius J" first="Jack R" last="Cornelius">Jack R. 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This study conducted a small-scale feasibility trial of Cognitive Enhancement Therapy (CET) in substance misusing schizophrenia patients to assess the feasibility and efficacy of implementing comprehensive neurocognitive and social-cognitive remediation in this population. A total of 31 schizophrenia outpatients meeting addiction severity criteria for alcohol and/or cannabis use were randomized to 18months of CET or usual care. Feasibility findings indicated high degrees of satisfaction with CET, but also presented significant challenges in the recruitment and retention of substance misusing patients, with high levels of attrition (50%) over the study period, primarily due to positive symptom exacerbation. Intent-to-treat efficacy analyses showed large and significant improvements in neurocognition (d=.86), social cognition (d=1.13), and social adjustment (d=.92) favoring CET. Further, individuals treated with CET were more likely to reduce alcohol use (67% in CET vs. 25% in usual care) during treatment (p=.021). These results suggest that once engaged and stabilized, CET is a feasible and potentially effective treatment for cognitive impairments in patients with schizophrenia who misuse alcohol and/or cannabis. Substance misusing patients who are able to engage in treatment may be able to benefit from cognitive remediation, and the treatment of cognitive impairments may help improve substance use outcomes among this underserved population.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">25510926</PMID><DateCreated><Year>2015</Year><Month>01</Month><Day>27</Day></DateCreated><DateCompleted><Year>2015</Year><Month>12</Month><Day>31</Day></DateCompleted><DateRevised><Year>2017</Year><Month>02</Month><Day>20</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1573-2509</ISSN><JournalIssue CitedMedium="Internet"><Volume>161</Volume><Issue>2-3</Issue><PubDate><Year>2015</Year><Month>Feb</Month></PubDate></JournalIssue><Title>Schizophrenia research</Title><ISOAbbreviation>Schizophr. Res.</ISOAbbreviation></Journal><ArticleTitle>Cognitive Enhancement Therapy in substance misusing schizophrenia: results of an 18-month feasibility trial.</ArticleTitle><Pagination><MedlinePgn>478-83</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.schres.2014.11.017</ELocationID><ELocationID EIdType="pii" ValidYN="Y">S0920-9964(14)00694-X</ELocationID><Abstract><AbstractText>Substance use is a frequent problem in schizophrenia, and although many substance misusing patients with the disorder also experience considerable cognitive impairments, such individuals have been routinely excluded from clinical trials of cognitive remediation that could support their functional and addiction recoveries. This study conducted a small-scale feasibility trial of Cognitive Enhancement Therapy (CET) in substance misusing schizophrenia patients to assess the feasibility and efficacy of implementing comprehensive neurocognitive and social-cognitive remediation in this population. A total of 31 schizophrenia outpatients meeting addiction severity criteria for alcohol and/or cannabis use were randomized to 18months of CET or usual care. Feasibility findings indicated high degrees of satisfaction with CET, but also presented significant challenges in the recruitment and retention of substance misusing patients, with high levels of attrition (50%) over the study period, primarily due to positive symptom exacerbation. Intent-to-treat efficacy analyses showed large and significant improvements in neurocognition (d=.86), social cognition (d=1.13), and social adjustment (d=.92) favoring CET. Further, individuals treated with CET were more likely to reduce alcohol use (67% in CET vs. 25% in usual care) during treatment (p=.021). These results suggest that once engaged and stabilized, CET is a feasible and potentially effective treatment for cognitive impairments in patients with schizophrenia who misuse alcohol and/or cannabis. Substance misusing patients who are able to engage in treatment may be able to benefit from cognitive remediation, and the treatment of cognitive impairments may help improve substance use outcomes among this underserved population.</AbstractText><CopyrightInformation>Copyright © 2014 Elsevier B.V. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Eack</LastName><ForeName>Shaun M</ForeName><Initials>SM</Initials><AffiliationInfo><Affiliation>School of Social Work, University of Pittsburgh, United States; Department of Psychiatry, University of Pittsburgh School of Medicine, United States. Electronic address: sme12@pitt.edu.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hogarty</LastName><ForeName>Susan S</ForeName><Initials>SS</Initials><AffiliationInfo><Affiliation>Department of Psychiatry, University of Pittsburgh School of Medicine, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Greenwald</LastName><ForeName>Deborah P</ForeName><Initials>DP</Initials><AffiliationInfo><Affiliation>Department of Psychiatry, University of Pittsburgh School of Medicine, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Litschge</LastName><ForeName>Maralee Y</ForeName><Initials>MY</Initials><AffiliationInfo><Affiliation>Department of Psychiatry, University of Pittsburgh School of Medicine, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>McKnight</LastName><ForeName>Summer A F</ForeName><Initials>SA</Initials><AffiliationInfo><Affiliation>School of Social Work, University of Pittsburgh, United States; Department of Psychiatry, University of Pittsburgh School of Medicine, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bangalore</LastName><ForeName>Srihari S</ForeName><Initials>SS</Initials><AffiliationInfo><Affiliation>Department of Psychiatry, University of Pittsburgh School of Medicine, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pogue-Geile</LastName><ForeName>Michael F</ForeName><Initials>MF</Initials><AffiliationInfo><Affiliation>Department of Psychology, University of Pittsburgh, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Keshavan</LastName><ForeName>Matcheri S</ForeName><Initials>MS</Initials><AffiliationInfo><Affiliation>Department of Psychiatry, Harvard Medical School, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cornelius</LastName><ForeName>Jack R</ForeName><Initials>JR</Initials><AffiliationInfo><Affiliation>Department of Psychiatry, University of Pittsburgh School of Medicine, United States.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>K23 MH095783</GrantID><Acronym>MH</Acronym><Agency>NIMH NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>KL2 RR024154</GrantID><Acronym>RR</Acronym><Agency>NCRR NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>KL2 TR000146</GrantID><Acronym>TR</Acronym><Agency>NCATS NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>K12 RR024154</GrantID><Acronym>RR</Acronym><Agency>NCRR NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R21 AA022863</GrantID><Acronym>AA</Acronym><Agency>NIAAA NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R21 DA030763</GrantID><Acronym>DA</Acronym><Agency>NIDA NIH HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016449">Randomized Controlled Trial</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2014</Year><Month>12</Month><Day>12</Day></ArticleDate></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>Schizophr Res</MedlineTA><NlmUniqueID>8804207</NlmUniqueID><ISSNLinking>0920-9964</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>Psychiatr Serv. 2009 Nov;60(11):1468-76</RefSource><PMID Version="1">19880464</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Clin Psychiatry. 2008 Jan;69(1):106-13</RefSource><PMID Version="1">18312044</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Arch Gen Psychiatry. 1974 Nov;31(5):609-18</RefSource><PMID 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Version="1">10755673</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000437" MajorTopicYN="N">Alcoholism</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName><QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003071" MajorTopicYN="N">Cognition</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015928" MajorTopicYN="N">Cognitive Therapy</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005240" MajorTopicYN="N">Feasibility Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002189" MajorTopicYN="N">Marijuana Abuse</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName><QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011618" MajorTopicYN="N">Psychotic Disorders</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012559" MajorTopicYN="N">Schizophrenia</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012565" MajorTopicYN="N">Schizophrenic Psychology</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012917" MajorTopicYN="N">Social Adjustment</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012938" MajorTopicYN="N">Social Perception</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList><OtherID Source="NLM">NIHMS644268</OtherID><OtherID Source="NLM">PMC4308498</OtherID><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Cognitive rehabilitation</Keyword><Keyword MajorTopicYN="N">Cognitive remediation</Keyword><Keyword MajorTopicYN="N">Drug use</Keyword><Keyword MajorTopicYN="N">Social cognition</Keyword><Keyword MajorTopicYN="N">Substance use</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2014</Year><Month>09</Month><Day>16</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2014</Year><Month>11</Month><Day>13</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2014</Year><Month>11</Month><Day>17</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2014</Year><Month>12</Month><Day>17</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2014</Year><Month>12</Month><Day>17</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2016</Year><Month>1</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">25510926</ArticleId><ArticleId IdType="pii">S0920-9964(14)00694-X</ArticleId><ArticleId IdType="doi">10.1016/j.schres.2014.11.017</ArticleId><ArticleId IdType="pmc">PMC4308498</ArticleId><ArticleId IdType="mid">NIHMS644268</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>États-Unis</li></country><region><li>Pennsylvanie</li></region><settlement><li>Pittsburgh</li></settlement><orgName><li>Université de Pittsburgh</li></orgName></list><tree><country name="États-Unis"><region name="Pennsylvanie"><name sortKey="Eack, Shaun M" sort="Eack, Shaun M" uniqKey="Eack S" first="Shaun M" last="Eack">Shaun M. Eack</name></region><name sortKey="Bangalore, Srihari S" sort="Bangalore, Srihari S" uniqKey="Bangalore S" first="Srihari S" last="Bangalore">Srihari S. Bangalore</name><name sortKey="Cornelius, Jack R" sort="Cornelius, Jack R" uniqKey="Cornelius J" first="Jack R" last="Cornelius">Jack R. Cornelius</name><name sortKey="Greenwald, Deborah P" sort="Greenwald, Deborah P" uniqKey="Greenwald D" first="Deborah P" last="Greenwald">Deborah P. Greenwald</name><name sortKey="Hogarty, Susan S" sort="Hogarty, Susan S" uniqKey="Hogarty S" first="Susan S" last="Hogarty">Susan S. Hogarty</name><name sortKey="Keshavan, Matcheri S" sort="Keshavan, Matcheri S" uniqKey="Keshavan M" first="Matcheri S" last="Keshavan">Matcheri S. Keshavan</name><name sortKey="Litschge, Maralee Y" sort="Litschge, Maralee Y" uniqKey="Litschge M" first="Maralee Y" last="Litschge">Maralee Y. Litschge</name><name sortKey="Mcknight, Summer A F" sort="Mcknight, Summer A F" uniqKey="Mcknight S" first="Summer A F" last="Mcknight">Summer A F. Mcknight</name><name sortKey="Pogue Geile, Michael F" sort="Pogue Geile, Michael F" uniqKey="Pogue Geile M" first="Michael F" last="Pogue-Geile">Michael F. Pogue-Geile</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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